Should I say something?

amother

Chocolate

Thu, Sep 29 2016, 7:43 pm

My child is approved for OT individually. The OT in school is seeing my child in a group of 3, which my child is happy about. I'm not sure I want to complain because my child prefers the group setting.
But how is the OT billing? The OT can't be billing as a group because my child is approved for one on one only. So is the OT working for a half hour and billing for an hour and a half, for each child individually??
It's bothering me because it's wrong but I'm not sure if I should say something and to whom. There is no "service coordinator" in the school, just principals and secretaries.
I already made a casual comment to the OT and the response was that the school is being tight on scheduling so this is the only way the teacher lets.

seeker

Thu, Sep 29 2016, 8:47 pm

Sounds kind of fishy.
You can get the mandate changed to group sessions but I'm not sure that's to your advantage.
If you're satisfied with the service you're getting then it's not your problem. You asked for individual and have no control over whether the school or provider decides to bend or break the rules when you're not even there. On the provider's head be it.
But on the provider's end, it's wrong. If the school will only allow pull-outs during that limited time frame, then she should tell the school she can only serve a limited number of students (I.e. one per period.) They have a choice of allowing more times, bringing in more providers, or telling parents to get their own providers after school (don't underestimate the PITN that can be... but on the other hand does your school setup allow for things like gym equipment which private OTs often have?)

amother

Smokey

Thu, Sep 29 2016, 10:33 pm

I don't think you should say anything to anyone.
If you wouldn't be happy with DD getting group sessions, that would be another story.

I wonder myself how she is billing. I am a speech therapist working in schools so I have similar predicaments in which scheduling is tight and teachers/admin do not let you take kids out.
In my old school, if that happened I would group them. But then I billed as one session. So it really was an added burden for me to group since no extra pay but extra paperwork at home. I refused to do what people told me to do, to bill as separate sessions. I think some agencies tell their providers to do that though. So I'm not sure how bad it really is. I just didn't feel comfortable.
But wait, I was only able to do that if kid was mandated for group. If kid is mandated as individual it can't be billed as group..
In my current school I don't group, so if teacher gives me a hard time scheduling, I'll just say forget about it.

Again, you don't want to be a tattle. Why would you tell on her just because? I know lots of ppl doing wrong things. I don't tell anyone on them. Unless it would affect me negatively.

TwinsMommy

Thu, Sep 29 2016, 11:05 pm

Is everyone in the group the same age/ skill level and working on the same goals? Then it might make sense. For instance, my daughter really should no longer be getting individual speech because her receptive and expressive is FINE-- now she NEEDS to work on group social skills---- conversation topic changes, asking and answering questions, etc---- so I like that she has GROUP speech therapy/ social skills at school and that she doesn't get invididual. But when the kid is so off of what the group is doing, it's really hard for the therapist to balance, I would think--- especially in a half hour or less.

If it's at school and covered by the district in the IEP, why is insurance being billed?

seeker

Thu, Sep 29 2016, 11:07 pm

Just to clarify, you can (technically, legally, etc, confirmed with experts in the field) have another child along in an individual session, just you're providing the therapy to one child at a time, billing for one child at a time, and not billing for time you didn't work.
FOR EXAMPLE: Let's say I have a student who is very sociable and not very interested in being pulled out for therapy. If it's OK with the school, I can pull out a friend together with this student. The friend might benefit from his participation, but I'm only billing for the first student and I'm only structuring the lesson around the first student's goals. This is definitely kosher.
LEVEL UP: A colleague had two students with similar needs who get along well and have short attention spans. Each one was mandated for thirty minutes of individual therapy. She took them both to the therapy room together for a full hour. Over the course of the hour both kids received an approximately equal amount of therapy targeted to their individual goals. They mainly did this by taking turns (recall the short attention span.) She'd work more hands-on with one child for three minutes while the other child was more in the background, then she'd move on to the other child while the first one got a chance to just play around. She billed half of that hour to one student and the other half of that hour to the other student. I believe this is kosher.

amother

Chocolate

Thu, Sep 29 2016, 11:16 pm

Who said insurance is being billed? Its through BOE, but I'm not even sure which agency, probably omni? I know who the other children are but not what their needs are. The OT said he will be working on handwriting and s couple other things I forgot. I told him my child needs sensory and social skills, so he made a comment about going to the gym sometimes. My child enjoys because he makes contests and races between them. I think he uses tablet as well sometimes which I'm not thrilled about but not sure there's much of a point in making a big deal about it in this day and age. I could try to refuse the sevices and get it released and go to someone privately which I'd prefer but is always such a big deal and no guarantee I will get the rsa. Wish I could meet the guy and observe a session...

amother

Chocolate

Thu, Sep 29 2016, 11:18 pm

seeker wrote:

No its 3 children for a half hour